Navegando por Palavras-chave "Auras"

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    Auras and clinical features in temporal lobe epilepsy: A new approach on the basis of voxel-based morphometry
    (Elsevier B.V., 2010-05-01) Castilho Garcia Santana, Maria Teresa [UNIFESP]; Jackowski, Andrea Parolin [UNIFESP]; Silva, Henrique Hattori da [UNIFESP]; Sales Ferreira Caboclo, Luis Otavio [UNIFESP]; Centeno, Ricardo Silva [UNIFESP]; Bressan, Rodrigo A. [UNIFESP]; Carrete, Henrique [UNIFESP]; Targas Yacubian, Elza Marcia [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    MRI investigations in patients with temporal lobe epilepsy (TLE) with mesial temporal sclerosis (MTS) have demonstrated structural abnormalities extending beyond ipsilateral hippocampus which may be studied through voxel-based morphometry (VBM). We investigated brain morphology related to clinical features in patients with refractory TLE with MIS using VBM. One hundred patients with unilateral TLE with MTS (59 left) and 30 controls were enrolled. VBM5 was employed to analyze (1) hemispheric damage, (2) influence of initial precipitating injury (IPI): 23 patients with febrile seizures and 19 with status epilepticus, and (3) types of auras classified as: mesial, including psychic auras (19 patients); anterior mesio-lateral, as autonomic symptoms, specially epigastric auras (27 patients) and neocortical, which included auditory, vertiginous, somatosensory and visual auras (16 patients). (1) Left TLE patients presented more widespread gray matter volume (GMV) reductions affecting ipsilateral hippocampus, temporal neocortex, insula and also left uncus, precentral gyrus, thalamus, parietal lobule, cuneus and bilateral cingulum. (2) Febrile seizures group presented ipsilateral GMV reductions in hippocampus, neocortical temporal, frontal and occipital cortices, insula and cingulum. Status epilepticus group presented more widespread GMV reductions involving temporal and amygdala, particularly right TLE group, who presented greater extension of GMV reduction in the entorhinal cortex. Significant reductions in hippocampus, amygdala and insula were seen in patients with anterior mesio-lateral auras. This study evaluated a large number of TLE-MTS patients showing structural damage extending beyond hippocampus, and different types of IPI associated with the extension of brain damage. Subtypes of auras are related to different clusters of areas of GMV reductions in VBM. for the first time, we have demonstrated GMV reductions anatomically correspondent to psychic (mesial areas) and autonomic auras (mesial and insular areas) reproducing previous cortical stimulation studies. (C) 2010 Elsevier B.V. All rights reserved.
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    Auras in temporal lobe epilepsy with hippocampal sclerosis: Relation to seizure focus laterality and post surgical outcome
    (Elsevier B.V., 2012-05-01) Ferrari-Marinho, Taissa [UNIFESP]; Caboclo, Luís Otávio Sales Ferreira [UNIFESP]; Marinho, Murilo Martinez [UNIFESP]; Centeno, Ricardo Silva [UNIFESP]; Neves, Rafael Scarpa da Costa [UNIFESP]; Santana, Maria Teresa Castilho Garcia de [UNIFESP]; Britto, Fernanda dos Santos [UNIFESP]; Carrete Junior, Henrique [UNIFESP]; Yacubian, Elza Márcia Targas [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    We examined the relationship between presence and frequency of different types of auras and side of lesion and post surgical outcomes in 205 patients with medically intractable mesial temporal lobe epilepsy (MTLE) with unilateral hippocampal sclerosis (HS). With respect to the number of auras, multiple auras were not associated with side of lesion (p=0.551). the side of HS was not associated with the type of auras reported. One hundred fifty-seven patients were operated. the occurrence of multiple auras was not associated with post-surgical outcome (p=0.740). the presence of extratemporal auras was significantly higher in patients with poor outcome. in conclusion, this study suggests that the presence of extratemporal auras in patients with MTLE-HS possibly reflects extratemporal epileptogenicity in these patients, who otherwise showed features suggestive of TLE. Therefore, TLE-HS patients undergoing pre-surgical evaluation and presenting clinical symptoms suggestive of extratemporal involvement should bemore extensively evaluated to avoid incomplete resection of the epileptogenic zone. (C) 2012 Elsevier Inc. All rights reserved.